Insurance Claims Process Management for a Healthcare IT Company

Exponential Growth Overloads Internal Process Management

A rapidly growing, venture capital-backed healthcare IT business sought to maintain its growth trajectory after raising over $50 million in funding. The client provided flu vaccinations to over 1 million students across U.S. public schools each fall, and their digital health platform helped schools maintain compliance and manage chronic diseases.

As the client experienced the quick, exponential growth common of venture capital-backed companies, they encountered a challenging bottleneck. Each student enrolled in their program had to be verified for insurance coverage. The insurance qualification and claims process, which tended to be time consuming and unwieldy, became increasingly overwhelming for existing staff to manage. Struggling to cope internally, the client initially addressed the problem by bringing on a 10-person team of seasonal employees. While this temporary staff was able to keep up with the paperwork and requirements for 100,000 students per year in the company’s early stages, the volume became increasingly difficult for the client to manage. Finding consistent and reliable seasonal labor developed into a challenge of its own to administer.